How much rates vary
Facilitymedian $832 · 10th to 90th $141 to $6,761Professionalmedian $204 · 10th to 90th $141 to $324
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $501.19 | Facility | None | $141.25 | $245.47 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $363.08 | Professional | None | $251.19 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $275.42 | Professional | None | $138.04 | $190.55 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $316.23 | Facility | None | $151.36 | $213.80 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $346.74 | Professional | None | $186.21 | $251.19 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $229.09 Typical High $263.03 | Facility | None | $34.67 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $1,348.96 | Professional | None | $158.49 | $257.04 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $363.08 | Professional | None | $154.88 | $223.87 | $363.08 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $70.79 Median $114.82 Typical High $128.82 | Facility | 52 · Reduced service | $70.79 | $114.82 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $51.29 | Facility | 53 · Discontinued | $28.18 | $45.71 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $194.98 | Facility | 54 · Surgery only | $107.15 | $169.82 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $34.67 Typical High $38.90 | Facility | 55 · Aftercare only | $21.38 | $34.67 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $25.70 | Facility | 56 · Pre-op care only | $14.13 | $22.91 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $158.49 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $100.00 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $70.79 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $28.18 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $107.15 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.13 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $100.00 | $158.49 | $181.97 |
Where Kentucky sits
The same service costs 3.4 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 51st of 51
$204
AK $692KY $204
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.